LONDON, July 7 (Reuters) - Groups tackling AIDS must make better use of scarce funds if they are to reach the goal of universal access to treatment, the U.N. AIDS chief said.
Gottfried Hirnschall, the new director of HIV/AIDS at the UN’s World Health Organisation took up his post in May at a time when some international donors suffering hard times are freezing or cutting donations to projects to fight the disease.
He is naturally eager to push donors to keep up their contributions and increase them if they can, but also wants to use a global conference on AIDS from July 18-23 to hammer home the message that better use of current funds is vital.
"The conference is happening at a really interesting time where there is a lot of discussion about funding levelling off and competition for resources. The question is how we position the whole HIV agenda in that broader context," Hirnschall told Reuters in a telephone interview from his Geneva office.
"We need to shift the conversation towards asking how we can use resources that we have more efficiently and effectively."
COST ANALYSIS The International AIDS Conference is held every two years and brings together around 25,000 scientists, officials, health workers, activists, corporate leaders, and people living with HIV/AIDS — of which there are 33 million around the world.
Since 2010 was a deadline set by world leaders for universal access to treatment for all HIV/AIDS patients, this year’s conference in Vienna coincides with a major push to reach that goal, although most campaigners say the target will be missed.
It also coincides with a global economic crisis which is hitting funding levels — a factor campaigners say is already putting lives at risk.
Hirnschall said the WHO was looking closely at the balance of drug costs to "systems costs", for things like health services, appointments, diagnostic and laboratory tests.
"About 20 to 30 percent of the costs related to treatment are drug-related costs, and the other 70 to 80 percent are systems and delivery costs," he said.
Enormous international pressure has forced manufacturers to slash prices of AIDS drugs, but Hirnschall said there was room for more negotiation — particularly on second-and third-line treatment drugs used when first-line medications do not work.
AIDS is caused by the incurable human immunodeficiency virus (HIV) and is transmitted mostly through sex. Major makers of AIDS drugs include GlaxoSmithKline, Gilead Sciences, Roche, Pfizer, Merck & Co, Bristol-Myers Squibb and Abbott Laboratories.
Hirnschall said pressure on drug companies should be matched by commitments to more innovative ways of using health workers and local systems to care for patients.
He noted a recent study in South Africa into an idea known as "task-shifting" which found nurses were as good as doctors at monitoring AIDS treatment.
SYSTEMS SHOULD BE SIMPLER, MORE LOCAL
"We also need simpler tests that can be used on a larger scale in the field and take away the need for the big lab infrastructure that is needed at the moment," he said, adding that more effective drugs were also needed.
The United Nations estimates that more than half of the 9.5 million people who need AIDS drugs cannot get them, and the WHO has recently issued new guidelines which lower the recommended threshold for starting a patient on medication.
Hirnschall said the new guidelines would mean that "over time, countries will have to increase the numbers of people on treatment by about a third".
He acknowledged this would push costs up, but said earlier treatment would help slow the spread of the disease.
